Maintaining Competence and Leadership in Manual Medicine
http://www.100md.com
《中华首席医学网》
To the Editor: Norman Gevitz, PhD, provides a thoughtful critique of the osteopathic medical profession and its educational system in his editorial in the March 2006 issue of JAOA—The Journal of the American Osteopathic Association ("Center or periphery? The future of osteopathic principles and practices." 2006;106: 121–129).
During the 1940s, when I was a student and teacher at the Chicago College of Osteopathic Medicine (CCOM), which is now part of the Midwestern University/Chicago College of Osteopathic Medicine (MWU/CCOM), COMs that had the strongest administrative leadership and most committed osteopathic clinical faculty also had the strongest osteopathic teaching programs. Such programs were widely recognized by the osteopathic medical profession for the high quality of their graduates. The programs had faculty who were trained in established osteopathic principles and practice (OPP) and who, through their teaching, helped create a continuity of skills in osteopathic manipulative treatment (OMT).
At CCOM in the 1940s, the teaching of these skills was based on the physiologic motion of the spine—principles of thoracic and lumbar spinal motion that were first described by CCOM graduate Harrison H. Fryette, DO.1 A logical program of skills development was conducted at CCOM based on palpatory and manipulative techniques emphasizing diagnostic and treatment procedures.
The teaching of OMT at COMs has usually been shaped by the predominance of certain colleges for limited periods. The leadership of any given teaching program is usually dominated by one individual with recognized skills who attracts others with similar skills. Invariably, this leader is engaged in research, which attracts both faculty and student interest. Unfortunately, interest in these programs often declines with the retirement of the leaders. Continuing strong leadership in OMT training requires strong administrative support and direction. Unfortunately, my observation has been that, all too often, new leadership at COMs has reduced support for training in OMT.
A college program led by an osteopathic physician who actually uses OMT in his or her practice produces a stronger educational experience for osteopathic medical students than do programs that lack such teachers. In addition, COMs that have active research programs in musculoskeletal medicine have stronger teaching programs.
It has long been one of my tenets that the proper teaching of OMT skills requires the following: (1) assessing the knowledge, motor skills, and aptitudes of osteopathic medical students; (2) training the students in OMT skills; (3) providing the students with opportunities to practice OMT under supervision; and (4) allowing the students to use their skills in clinical situations to build confidence.
Among the programs that have been most successful in promoting osteopathic skills and principles are the fellowship programs sponsored by COMs. In addition to completing the standard COM curriculum, students in these fellowships spend an additional year in skills training, teaching, or research. The Chicago college was one of the first COMs to institute such a program. I believe that at least two graduates of the CCOM program became OPP faculty at Michigan State University College of Osteopathic Medicine (MSUCOM) in East Lansing. Furthermore, several of the graduates from the MSUCOM fellowship program have been active in teaching and research.
It is incumbent on the osteopathic medical profession to provide quality education in OPP if it is to maintain a leadership position in the field of manual medicine. In view of the widespread interest in manual medicine and manual therapy in the United States and abroad—and the wide variety of professionals who practice manual medicine and therapy—I believe the main role of the osteopathic medical profession should be maintaining standards of competence in this field and providing leadership in research.
Footnotes
Editor's note: The American Academy of Osteopathy has honored Dr Beal by publishing a collection of his work in The 2005 American Academy of Osteopathy Yearbook, Contributions to Osteopathic Literature—Myron C. Beal, DO, FAAO.
References
1. Glossary Review Committee for the Educational Council on Osteopathic Principles of the American Association of Colleges of Osteopathic Medicine. Glossary of Osteopathic Terminology. April 2002. Available at: http://www.do-online.osteotech.org/pdf/sir_college-gloss.pdf. Accessed May 10, 2006
Canandaigua, NY Professor Emeritus Michigan State University College of Osteopathic Medicine East Lansing, Mich(MYRON C. BEAL, DO, MS)
During the 1940s, when I was a student and teacher at the Chicago College of Osteopathic Medicine (CCOM), which is now part of the Midwestern University/Chicago College of Osteopathic Medicine (MWU/CCOM), COMs that had the strongest administrative leadership and most committed osteopathic clinical faculty also had the strongest osteopathic teaching programs. Such programs were widely recognized by the osteopathic medical profession for the high quality of their graduates. The programs had faculty who were trained in established osteopathic principles and practice (OPP) and who, through their teaching, helped create a continuity of skills in osteopathic manipulative treatment (OMT).
At CCOM in the 1940s, the teaching of these skills was based on the physiologic motion of the spine—principles of thoracic and lumbar spinal motion that were first described by CCOM graduate Harrison H. Fryette, DO.1 A logical program of skills development was conducted at CCOM based on palpatory and manipulative techniques emphasizing diagnostic and treatment procedures.
The teaching of OMT at COMs has usually been shaped by the predominance of certain colleges for limited periods. The leadership of any given teaching program is usually dominated by one individual with recognized skills who attracts others with similar skills. Invariably, this leader is engaged in research, which attracts both faculty and student interest. Unfortunately, interest in these programs often declines with the retirement of the leaders. Continuing strong leadership in OMT training requires strong administrative support and direction. Unfortunately, my observation has been that, all too often, new leadership at COMs has reduced support for training in OMT.
A college program led by an osteopathic physician who actually uses OMT in his or her practice produces a stronger educational experience for osteopathic medical students than do programs that lack such teachers. In addition, COMs that have active research programs in musculoskeletal medicine have stronger teaching programs.
It has long been one of my tenets that the proper teaching of OMT skills requires the following: (1) assessing the knowledge, motor skills, and aptitudes of osteopathic medical students; (2) training the students in OMT skills; (3) providing the students with opportunities to practice OMT under supervision; and (4) allowing the students to use their skills in clinical situations to build confidence.
Among the programs that have been most successful in promoting osteopathic skills and principles are the fellowship programs sponsored by COMs. In addition to completing the standard COM curriculum, students in these fellowships spend an additional year in skills training, teaching, or research. The Chicago college was one of the first COMs to institute such a program. I believe that at least two graduates of the CCOM program became OPP faculty at Michigan State University College of Osteopathic Medicine (MSUCOM) in East Lansing. Furthermore, several of the graduates from the MSUCOM fellowship program have been active in teaching and research.
It is incumbent on the osteopathic medical profession to provide quality education in OPP if it is to maintain a leadership position in the field of manual medicine. In view of the widespread interest in manual medicine and manual therapy in the United States and abroad—and the wide variety of professionals who practice manual medicine and therapy—I believe the main role of the osteopathic medical profession should be maintaining standards of competence in this field and providing leadership in research.
Footnotes
Editor's note: The American Academy of Osteopathy has honored Dr Beal by publishing a collection of his work in The 2005 American Academy of Osteopathy Yearbook, Contributions to Osteopathic Literature—Myron C. Beal, DO, FAAO.
References
1. Glossary Review Committee for the Educational Council on Osteopathic Principles of the American Association of Colleges of Osteopathic Medicine. Glossary of Osteopathic Terminology. April 2002. Available at: http://www.do-online.osteotech.org/pdf/sir_college-gloss.pdf. Accessed May 10, 2006
Canandaigua, NY Professor Emeritus Michigan State University College of Osteopathic Medicine East Lansing, Mich(MYRON C. BEAL, DO, MS)